Year: 2026 | Month: July | Volume: 16 | Issue: 7 | Pages: 104-112
DOI: https://doi.org/10.52403/ijhsr.20260711
Clinical, Radiological, and Functional Outcomes of Open Long Bone Fractures Treated Primarily with the Limb Reconstruction System: A Prospective Observational Study
Devansh Agarwal1, Suresh K. Kaushik2, Sanjay Gupta3, Anup Kumar4, Aditya Sharma5, Harshvardhan Buddhist6
1-6Department of Orthopaedics, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
Corresponding Author: Devansh Agarwal
ABSTRACT
Background: Open long bone fractures are associated with significant soft tissue injury, infection, delayed union, and functional impairment. The Limb Reconstruction System (LRS) provides stable external fixation while facilitating soft tissue management and early rehabilitation. However, prospective evidence regarding its clinical and functional outcomes remains limited.
Objective: To evaluate the clinical, radiological, and functional outcomes of open long bone fractures treated primarily with the Limb Reconstruction System (LRS).
Materials and Methods: This prospective observational study was conducted at the Department of Orthopaedics, SRMS Institute of Medical Sciences, Bareilly, India, between April 2024 and September 2025. Of the 24 patients assessed for eligibility, 19 completed the 24-week follow-up and were included in the final analysis. Clinical and radiological outcomes were assessed using the Modified Johner and Wruhs criteria, Association for the Study and Application of Methods of Ilizarov (ASAMI) bone and functional criteria, radiological union, weight-bearing status, and postoperative complications. Fisher's exact test was used to evaluate the association between Gustilo–Anderson fracture grade and treatment outcomes.
Results: The mean age of the participants was 36.4 ± 10.7 years, and 78.9% were males. Tibial fractures accounted for 78.9% of injuries. The mean time to definitive fixation was 7.4 ± 2.8 hours, while radiological union was achieved in 18 (94.7%) patients at a mean of 18.3 ± 4.1 weeks. Excellent outcomes were observed in 52.6% of patients according to the Modified Johner and Wruhs criteria, 73.7% according to the ASAMI bone criteria, and 63.2% according to the ASAMI functional criteria. Superficial pin tract infection was the most common complication (36.8%). Although patients with Gustilo type IIIB fractures showed comparatively poorer outcomes, the association was not statistically significant (p>0.05).
Conclusion: Primary LRS fixation achieved satisfactory fracture union, favorable functional recovery, and an acceptable complication profile, supporting its use as an effective treatment option for selected open long bone fractures.
Key words: Open fracture; Limb Reconstruction System; External fixation; Functional outcome; Radiological union; ASAMI; Gustilo–Anderson classification.